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<p>This prospective interventional case study aimed to describe the anatomical and functional outcomes of pars plana vitrectomy (PPV) with adjunct highly concentrated autologous platelet-rich plasma (PRP) in patients with symptomatic, progressive lamellar macular hole (LMH) over an extended follow-up period. 20 eyes of 20 patients were included with a minimum follow-up of 24&#xa0;months (mean 40.2 ± 11.8&#xa0;months) and a morphological diagnosis of LMH. 23-/25-gauge PPV was conducted with peeling of the internal limiting membrane (ILM) and epiretinal proliferation (ERP; if present) with intraoperative application of autologous PRP under air or gas tamponade. Combined phacovitrectomy was performed in phakic eyes. Foveal anatomy was restored in all cases at first follow-up. Best-corrected visual acuity (BCVA) significantly improved from 0.36 ± 0.16 logMAR to 0.19 ± 0.24 logMAR at final follow-up (mean 0.17 logMAR, <i>p</i> = 0.005). Central retinal thickness (CRT) increased significantly (<i>p</i> &lt; 0.001), indicating retinal restoration. Ellipsoid Zone (EZ) defects, initially present in 80% of patients, fully resolved in 62.5% with a significant reduction of defect width (<i>p</i> = 0.005). Microperimetry was stable throughout the entire follow-up. Three patients developed recurrent defects possibly attributable to insufficient peeling or postoperative position. No other significant intra- or postoperative complications were recorded. Autologous PRP in LMH surgery is safe and might be an effective adjuvant, potentially offering long-term anatomical stability and functional recovery while reducing the risk of postoperative complications. Those observed effects are exploratory as the cohort size is small and a control group is missing. A main strength of our study is the extended follow-up period which is essential to capture all possible regeneration mechanism.</p>

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Extended follow-up of ultrastructural remodeling and functional recovery after lamellar macular hole surgery using autologous platelet-rich plasma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月24日

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  • Elisa Vanessa Osterode,
  • Lina Sophie Farhoumand,
  • Lara Buhl,
  • Benedikt Schworm,
  • Thomas Christian Kreutzer,
  • Julian Elias Klaas,
  • Felix Hagenau,
  • Siegfried Georg Priglinger

摘要

This prospective interventional case study aimed to describe the anatomical and functional outcomes of pars plana vitrectomy (PPV) with adjunct highly concentrated autologous platelet-rich plasma (PRP) in patients with symptomatic, progressive lamellar macular hole (LMH) over an extended follow-up period. 20 eyes of 20 patients were included with a minimum follow-up of 24 months (mean 40.2 ± 11.8 months) and a morphological diagnosis of LMH. 23-/25-gauge PPV was conducted with peeling of the internal limiting membrane (ILM) and epiretinal proliferation (ERP; if present) with intraoperative application of autologous PRP under air or gas tamponade. Combined phacovitrectomy was performed in phakic eyes. Foveal anatomy was restored in all cases at first follow-up. Best-corrected visual acuity (BCVA) significantly improved from 0.36 ± 0.16 logMAR to 0.19 ± 0.24 logMAR at final follow-up (mean 0.17 logMAR, p = 0.005). Central retinal thickness (CRT) increased significantly (p < 0.001), indicating retinal restoration. Ellipsoid Zone (EZ) defects, initially present in 80% of patients, fully resolved in 62.5% with a significant reduction of defect width (p = 0.005). Microperimetry was stable throughout the entire follow-up. Three patients developed recurrent defects possibly attributable to insufficient peeling or postoperative position. No other significant intra- or postoperative complications were recorded. Autologous PRP in LMH surgery is safe and might be an effective adjuvant, potentially offering long-term anatomical stability and functional recovery while reducing the risk of postoperative complications. Those observed effects are exploratory as the cohort size is small and a control group is missing. A main strength of our study is the extended follow-up period which is essential to capture all possible regeneration mechanism.